Jess Messel v. Wexford Health Sources, Inc.

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted June 30, 2026*
Decided July 22, 2026
Before
THOMAS L. KIRSCH II, Circuit Judge
JOHN Z. LEE, Circuit Judge
DORIS L. PRYOR, Circuit Judge
No. 25-2191
JESS MESSEL,
Plaintiff-Appellant,
v.
WEXFORD HEALTH SOURCES, INC.,
et al.,
Defendants-Appellees.
Appeal from the United States District
Court for the Southern District of
Indiana, Terre Haute Division.
No. 2:24-cv-00519-MPB-MJD
Matthew P. Brookman,
Judge.
O R D E R
Jess Messel, an Indiana prisoner, appeals the judgment dismissing his claims
against two prison doctors and their employers. See 42 U.S.C. § 1983. Messel alleges that
his medical providers violated his rights under the Eighth Amendment by failing to
adequately treat his heart condition, which caused him to suffer a stroke and permanent
* We have agreed to decide the case without oral argument because the brief and
record adequately present the facts and legal arguments, and oral argument would not
significantly aid the court. F ED. R. A PP . P. 34(a)(2)(C).
NONPRECEDENTIAL DISPOSITION
To be cited only in accordance with F ED. R. APP . P. 32.1

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nerve damage. The district court twice dismissed his complaint at screening for failure
to state a claim. See 28 U.S.C. § 1915A. Because the allegations in Messel’s complaint are
too conclusory to plausibly state a claim, we affirm.
Before his incarceration, Messel received two heart stents and was prescribed
Plavix, a brand-name medication used to reduce the risk of stroke. The physicians who
implanted the stents told him that he would need to take Plavix for the rest of his life
and warned that discontinuing the drug could be life-threatening. After Messel was
incarcerated at Wabash Valley Correctional Facility, however, his Plavix prescription
was discontinued. Messel then suffered a stroke, which caused nerve damage in his toes
and fingers. After the stroke, Messel’s physicians reinstated his Plavix prescription.
Messel then sued Wexford Health Sources, Inc. and Centurion Health of Indiana,
LLC—the private companies contracted by Indiana to provide medical services in its
prisons—alleging that they were deliberately indifferent to his serious medical needs in
violation of the Eighth Amendment by discontinuing his Plavix prescription.
At screening, 28 U.S.C. § 1915A, the district court explained that because liability
under 42 U.S.C. § 1983 generally cannot be based on a theory of respondeat superior,
Messel needed either to sue the physicians who ended his Plavix prescription, or to
allege that he was deprived of Plavix based on a policy, practice, or custom of Wexford
or Centurion.
Messel then filed an amended complaint adding two physicians, Dr. Samuel
Byrd and Dr. Rajoli, as defendants and alleging that his prescription ended “while
under the care of the defendants.” Messel also alleged that Wexford and Centurion
maintained policies that harmed him, including “cutting out expensive medications and
hiring … doctors who are subpar.”
The district court dismissed Messel’s amended complaint with prejudice,
concluding that Messel did not allege the physicians were personally involved in or
responsible for terminating his Plavix prescription, and the alleged policies were not
facially unconstitutional or obviously likely to place patients at risk of serious harm.
Messel appeals the judgment dismissing his amended complaint. We review
dismissals under § 1915A de novo, applying the standard for ordinary Rule 12(b)(6)
dismissals. Cesal v. Moats, 851 F.3d 714, 720 (7th Cir. 2017). We therefore “accept the
well-pleaded facts in the complaint as true, but legal conclusions and conclusory

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allegations merely reciting the elements of the claim are not entitled to this presumption
of truth.” McCauley v. City of Chicago, 671 F.3d 611, 616 (7th Cir. 2011).
We turn first to Messel’s claim against the physicians. Messel argues that he
alleged a plausible claim that the physicians were deliberately indifferent to his serious
medical needs. A prison physician violates the Eighth Amendment’s constraint against
cruel and unusual punishment by acting with deliberate indifference to a prisoner’s
serious medical need. See Estelle v. Gamble, 429 U.S. 97, 104 (1976). “To state a claim for
deliberate indifference for deficient medical care, the plaintiff ‘must allege an
objectively serious medical condition and an official’s deliberate indifference to that
condition.’” Cesal, 851 F.3d at 721 (quoting Perez v. Fenoglio, 792 F.3d 768, 776 (7th Cir.
2015)).
Here, Messel alleged that he suffered from a serious medical condition related to
the stents in his heart, which required life-long treatment with Plavix. And he alleged
that the physicians who implanted the stents warned him that discontinuing Plavix
would be life-threatening, but that his prescription nevertheless was terminated “while
under the care of the defendants.” As a result, Messel alleged, he suffered a stroke and
permanent nerve damage.
Although Messel’s amended complaint attributes the decision to discontinue
Plavix to the two named physicians, the remaining allegations are too sparse to
plausibly support a finding that the physicians acted recklessly or intentionally
disregarded a substantial risk of serious harm. See Estelle, 429 U.S. at 104. Messel did not
allege that the physicians knew about the stents or that other physicians had warned
that discontinuing Plavix would pose a serious risk. Indeed, Messel says nothing about
the treatment he received from Dr. Byrd and Dr. Rajoli or their decision to discontinue
his Plavix prescription. Instead, Messel provides only the conclusory allegation that
they followed cost-cutting policies. Other than speculation, the complaint does nothing
to tie the purported policies to his particular circumstance. In short, Messel has
provided no related factual allegations from which we could infer that the doctors
“actually kn[e]w about yet disregard[ed] a substantial risk of harm.” Rasho v. Elyea,
856 F.3d 469, 476 (7th Cir. 2017) (citing Petties v. Carter, 836 F.3d 722, 728 (7th Cir. 2016)
(en banc)). Without further support, these facts are too sparse and conclusory to state a
claim for deliberate indifference. See Peterson v. Wexford Health Sources, Inc., 986 F.3d 746,
753 (7th Cir. 2021).
We next consider Messel’s claim against Wexford and Centurion. Messel argues
that he sufficiently alleged that the corporations’ cost-saving policies and practice of

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hiring unqualified physicians were a driving force behind the doctors’ decision to
discontinue his medication.
To state a claim against Wexford and Centurion, Messel was required to
plausibly allege that the corporations maintained a widespread policy, custom, or
practice that caused a deprivation of his constitutional rights. See Monell v. Dep’t Soc.
Servs., 436 U.S. 658, 694–95 (1978); Glisson v. Ind. Dep’t of Corr., 849 F.3d 372, 378–79
(7th Cir. 2017) (en banc). Because Messel does not assert that Wexford and Centurion
maintained policies that were facially unconstitutional, his allegations must plausibly
support a finding that the corporations’ policies or practices obviously would lead to
constitutional violations. See Clemons v. Wexford Health Sources, Inc., 106 F.4th 628, 638
(7th Cir. 2024). “The degree of specificity required is not easily quantified, but ‘the
plaintiff must give enough details about the subject-matter of the case to present a story
that holds together.’” McCauley, 671 F.3d at 616 (quoting Swanson v. Citibank, N.A., 614
F.3d 400, 404 (7th Cir. 2010)).
Here, Messel’s allegations are too sparse and conclusory to state a plausible claim
for relief. Messel alleges only that the corporate defendants maintained a practice of
“cost savings measures,” including “cutting out expensive medications and hiring
and/or contracting doctors who are subpar and have had multiple lawsuits against
them in the past.” But these allegations are “legal conclusions or elements of the cause
of action” that do not contribute to the plausibility analysis at the pleading stage. Id.
at 618–19. Messel’s amended complaint is devoid of any factual content from which we
could plausibly infer that Wexford and Centurion maintained widespread practices that
obviously would lead to constitutional violations or that were the “moving force”
behind his particular injuries. Monell, 436 U.S. at 694. For example, he does not allege
that anyone stated or even suggested that cost was the reason for discontinuing Plavix.
Nor does he provide a basis to believe that Wexford and Centurion included Plavix (or
similar drugs) in their cost-cutting measures.
AFFIRMED

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